Laparoscopic cannula with suturing capability

Abstract

A cannula for use in laparoscopic surgery has a central passage which may accept a trocar to create a laparoscopic incision in a body wall to an inner body cavity. A tubular section of the cannula is then pressed into the incision to form a port. After completion of the operation a needle having a blunt distal end with a suture-engaging notch surrounded by a sheath with a sharpened edge is pressed through inclined passages in the side walls of the cannula so as to extend into the body tissue on one side of the cannula and into the body cavity, carrying the suture which is then grasped by an instrument to remove the suture and join it to a needle projecting from the opposite side of the cannula. The needle is then withdrawn so the suture may be knotted on the outer side of the body wall.

Having thus described my invention I claim: 
     
       1. A cannula for use in laparoscopic surgery performed through a wall of a body cavity, the cannula comprising:
 an elongated tubular section having interior walls open at both its proximal and distal ends and having a central axis; 
 a first passage through the walls of the tubular section, inclined with respect to the central axis, the first passage having a first opening through the wall of the tubular section adjacent the proximal end of the tubular section, and a second opening through the wall of the tubular section adjacent to the distal end of the tubular section at a position on the tubular wall opposed to the position of the first opening, the first and second openings being aligned so that a first straight suture needle may be passed through both the first and second openings with a section of the needle intermediate the first and second openings transversing the interior of the tubular section and with a distal end of the needle projecting out of the second opening and through the wall of the body cavity; 
 a first manually controllable valve disposed adjacent a proximal end of the first passage which may be placed in an open position to allow clearance for the needle or a closed position, when the needle is not in the first passage, to block the flow of gases through the first passage; 
 a conduit extending through the wall of the tubular section to connect to an insufflation gas source at an exterior of the wall at one end and the first passage at its other end; 
 a second valve disposed in said conduit; and 
 a gas valve extending across the interior of the tubular section on a proximal side of a connection between the conduit and the interior of the tubular section; 
 whereby the cannula can be used as a guide for a trocar to form an incision through the wall of the body cavity so that the cannula may be inserted through the incision, allowing the body cavity to be insufflated through said conduit in the body cavity, as a laparoscopic entry port, and as a device to allow suturing the cavity closed using the needle. 
 
     
     
       2. The cannula of  claim 1 , further including a second passage through the walls of the tubular section at a position opposed to the first passage, the second passage being inclined with respect to the central axis of the tubular section at an angle complementary to an angle of inclination of the first passage, so that extensions of the first and second passages cross one another in a center of the tubular section; whereby said first straight needle may be passed through the first passage and a second straight needle may be passed through the second passage. 
     
     
       3. The cannula of  claim 2 , wherein said gas valve extending across the interior of the tubular section on the proximal side of the connection between the conduit and the interior of the tubular section comprises a pair of opposed flaps adapted to be moved into a closed position by the gas pressure at such time as the body cavity has been insufflated and to allow the passage of instruments through the central passage from the proximal end of the central passage. 
     
     
       4. The cannula of  claim 2 , wherein said first and second passages are positioned on the tubular section so that extensions of the first and second passages are separated laterally from one another. 
     
     
       5. The cannula of  claim 1 , comprising a section of increased lateral dimension relative to a dimension of the exterior of the tubular section at a proximal end of the cannula with the first, second, and gas valves being located in the section of increased lateral dimension. 
     
     
       6. The cannula of  claim 5 , further including a termination at the distal end of the tubular section, inclined with respect to the central axis of the tubular section. 
     
     
       7. The cannula of  claim 1 , wherein said straight needle comprises a cylindrical section having a handle at its proximal end supporting a compression spring bearing against the needle to bias it in an axial direction away from the handle and an outer sheath having a sharpened distal end and a proximal end fixed on the handle, the cylindrical section comprising a blunt distal end having a suture-engaging aperture formed therein; whereby when said blunt end abuts body tissue, forces imposed on the handle move the cylindrical section against the bias imposed by the compression spring, allowing the sharpened end of the tubular section to extend beyond the blunt section of the cylindrical section and thereby cut abutting tissue.